The impact of prophylactic treatment on post-traumatic epilepsy after severe traumatic brain injury

Aim: To assess the incidence of late post-traumatic epilepsy ( PTE) in patients with very severe traumatic brain injury ( TBI) who either received or did not receive anti-epileptic prophylactic treatment. Methods: Two populations were studied: 55 patients retrospectively and 82 subjects prospectively. Results: Ten patients ( 18%) in the first population showed late PTE. Although the incidence was lower in patients who did not receive prophylactic treatment, the difference between the treated and the non-treated group was not statistically significant. Sixty-nine patients in the second group ( 84%) had prophylactic treatment. Twenty-seven patients ( 39%) suffered from late PTE during the 2-year follow-up period and 17 of them ( 63%) showed EEG epileptic abnormalities. No patient who did not receive preventive therapy suffered from late PTE during the observation period. Conclusions: Due to the negative cognitive effects of anti-epileptic drugs, the preliminary results are of considerable interest for the rehabilitation of patients with very severe TBI.